Effects of high-frequency jet ventilation on intracranial pressure in experimental head-brain injury

Based on experimental studies, ventilation with small volumes of gas and rates of up to 100-400/minute, high-frequency jet ventilation (HFJV), seems to present a true alternative to conventional intermittent positive pressure ventilation (IPPV), especially in patients with multiple organ damage. In order to determine the effects of high-frequency jet ventilation on intracranial pressure, we examined the effects of the HFJV in comparison to conventional ventilation in experimental balloon brain trauma. Ten young pigs were studied using continuous invasive hemodynamic, pulmonary, and intracranial pressure monitoring. There was no increase in brain pressure over normal ventilation. As a matter of fact, there was a temporary decrease of the intracranial pressure by about 5 mmHg, which returned to the initial pre-HFJV value after 5 minutes. In contrast to conventional ventilation, HFJV allows for tracheobronchial suctioning and interruption of ventilation without any noticeable increase of ICP.